Role Description The Xactimate Certified Reviewer plays a key back-office project management role supporting construction project scopes for FEMA and other federally funded disaster recovery programs. You will review inspection reports, develop and validate detailed scopes of work, and ensure all estimates adhere to program requirements, policies, and funding guidelines. This long-term, fully remote engagement offers significant ownership, visibility, and the opportunity to contribute to a large-scale housing and disaster recovery initiative in a fast-moving, compliance-focused environment. Responsibilities - Review property inspection reports and supporting documentation to understand damage conditions and project requirements. - Develop, validate, and refine detailed construction scopes of work using Xactimate, ensuring accuracy and completeness. - Ensure all estimates and scopes align with applicable policies, procedures, and program requirements for FEMA and federally funded recovery programs. - Collaborate closely with inspectors, project managers, adjusters, compliance teams, and other stakeholders to resolve discrepancies and ensure scope accuracy. - Review construction estimates for completeness, accuracy, and compliance with funding and program guidelines. - Support FEMA-related disaster recovery projects and other federally funded initiatives by providing expert scope and estimate review. - Analyze construction damage assessments and translate findings into detailed repair and reconstruction scopes for residential and/or commercial properties. - Maintain thorough documentation and adhere to strong quality control standards throughout the review and approval process. - Identify and help resolve scope, pricing, and compliance issues, escalating concerns and recommending solutions as needed. - Partner closely with compliance and project managers to align project scopes and estimates with policy and regulatory requirements. Qualifications - Active Xactimate Certification. - 5–8+ years of relevant experience in construction estimating, damage assessment, insurance restoration, or project scoping. - Hands-on experience using Xactimate RS to prepare and review construction estimates and reports. - Strong understanding of construction practices, repair methodologies, and cost estimating principles. - Experience reviewing and developing scopes of work for residential and/or commercial construction projects. - Ability to interpret inspection findings and convert them into accurate, policy-compliant estimates. - Experience supporting FEMA-funded projects and disaster recovery programs. - Strong analytical skills with the ability to assess complex damage and cost scenarios. - Strong organizational skills to manage documentation, multiple projects, and quality control requirements. - Clear and professional communication skills for collaborating with inspectors, project managers, adjusters, and compliance stakeholders. Requirements - Experience with CDBG-DR (Community Development Block Grant – Disaster Recovery) programs or other federally funded recovery initiatives. - Background as a Flood Adjuster or experience in flood-related damage assessment and claims. - Familiarity with compliance-heavy, government-funded program environments. - Interest in large-scale disaster recovery and housing programs. - Comfort working in a lean team with high levels of ownership and visibility. Benefits - Medical, dental & vision. - Critical Illness, Accident, and Hospital. - 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available. - Life Insurance (Voluntary Life & AD&D for the employee and dependents). - Short and long-term disability. - Health Spending Account (HSA). - Transportation benefits. - Employee Assistance Program. - Time Off/Leave (PTO, Vacation or Sick Leave). Work Environment This role is fully remote and open to various time zones. You will collaborate virtually with a lean, highly engaged team focused on a large-scale disaster recovery housing program and other federally funded initiatives. The environment is fast-moving and compliance-heavy, offering significant responsibility, autonomy, and visibility into high-impact recovery efforts. Job Type & Location This is a Contract position based out of Raleigh, NC. Pay and Benefits The pay range for this position is $41.00 - $44.00/hr. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: Application Deadline This position is anticipated to close on Jul 27, 2026.

• Provide medical and operational oversight for end-to-end medical review activities supporting global pharmacovigilance. • Conduct ICSR medical assessment, submission readiness, and quality evaluation. • Oversee ICSR coding standards, ensuring consistent application of coding conventions. • Provide medical expertise and support to Benefit-Risk activities and safety strategy as delegated. • Act as an SME during internal audits, vendor audits, and regulatory inspections. • Support the development and maintenance of the medical review process.

• Review acute and post-acute authorizations for medical necessity using InterQual guidelines • Collaborate with case managers, physicians, and medical directors to ensure appropriate levels of care • Participate in team meetings, educational activities, and interrater reliability testing to maintain review consistency and professional growth • Ensure compliance with federal, state, and accreditation standards, and identify opportunities to enhance communication or processes • Utilize knowledge of resources available in the healthcare system to assist physicians and patients effectively • Perform other job duties as assigned

• Perform clinical reviews of medical records and other documentation to validate issues of claims coding accuracy, medical necessity, and the appropriateness of treatment settings and services delivered. • Report to the Payment Assurance Senior Manager and support a culture and work environment that promotes and inspires an active, continuous improvement philosophy regarding products and services in line with our company mission. • Audits and analyzes neonatal intensive care unit (NICU) claims according to ICD-10 coding principles and clinical guidelines. • Analysis of claims data to optimize reimbursement by ensuring that the diagnosis codes, procedure codes, and supporting documentation accurately support the service rendered. • Ensure claims analysis complies with ethical coding standards, guidelines, and regulatory requirements. • Responsible for performing clinical reviews of medical records and other documentation to validate issues of claims coding accuracy, medical necessity, and the appropriateness of treatment settings and services delivered. • Utilize Clinical Review Tools and EMR Systems. • Research reimbursement regulations for claim payment compliance to support and validate audit findings. • Assist with the development of claims audit process documentation, including workflow diagrams, policies and procedures, and standard operating procedures. • Detect discrepancies in provider billing and recommend adjustments to ensure proper reimbursement.